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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FORiAPPLICATION TO BE ACCEPTED Date: Permit Number: 4,02- uos I i RECEIVED Building Permit Application MAR -3 2016.. Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential X, PERMIT APPLICATION FOR: Address: Legal Description: Property Tax lD#: Zi `"" �_ 3�� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Might Side: Left Side: E U Additionalwor to e pe Orme un er t is WiPec all that appy: _Mechanical _Gas Tank _Gas Piping M Shutters Xxindows/Doors Electric Plumbing T Sprinklers Y Generator Roof Total Sq. Ft of Construction: / r G Sq. Ft. of First Floor: Cost of Construction: $ e Q Utilities: —Sewer —Septic Building Height: 7Name + °E' �i C2�✓ Name: fe ir- 1� 0�� e Company: ('V'e r S �-�-C 1�! • �" l e,4'C'e. State: Address: Q 8 1 9 ©f Yt ^ Fax: City: b►' ct kl State:r .-- . �(�7 ' � Zip Code: 2 7U Fax-. Phone No. Q 7' simple Title Holder on next page(if different E-Mail: Owner listed above) State or Gobi p License: C 1Sv Wq 17 C w if value of construction is 2500 or more,a RECORDED4 N Ice of C-om me t s redti3z(,1�3 4 i SUPPLEMENTAL CONSTRUCTION OEN LAW INFORMATION DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: Zip: Phone: - Zip: ^ Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY Not Applicable Name: Name: Address: Address: City: city: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Own e s Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respct perform the work e in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amend me t . The following building perm' plications are exempt from undergoing a full concurrency revie : r m additions, accessory structures,swi Jur pools, fen es,walls;signs,screen rooms and accessory uses t ano er non-residential use WARNING TO OWN R: fai re t Record a Notice of Commencement may r suit- your paying twice for improvements to y ur pr per . A N tice of Commencement must be ret r ed a d post n the jobsite before the first ins ectio . I you int nd to obtain financing, consult with I der o an a orn y before commencin wor or rest din you Notice of Commencement. Signature of Own J Agent/Lessee Signature of Contr .tor/License Holder i STATE OF FL IDA STATE OF FLO DA COUNTY OF xNGE COUNTY OF OR 4GE __,.T The f aping i strum w acknowledge .�jefore!me The f r Ing ins ume t wAs acknowledge ore me this1/88y f �, 20 _ tr h} this ay c i PETER A CAFAR6 III I 1 PETER A(.AFARO til (Name of person acknowl (Name of person acknowle Ing J i I, CA A-- ( ignature f Notary Public-State of F orida ) i (Si nature o Notary Public-State bf Flor da 1 Personally Known x OR Produced identificatipn Personally Known x OR Produced identification_ Type of Identification Produced Type of Identification Produced r4 Commission No. EE 174164 - i R1f71iSS10n No. EE 174164 TP Y P Notary PuWiclStato of f lolidcf NotlTy t'tlgl c Stale of Flac,oa { ?'61`r ; Kari M RiCCaboni 1 Kari M RiCC bOni y My Commission EE iia 164 rAy Expires 0512812016 Revised 07/15/2014 } � p��� ixp les 05!28iY2016 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE --- COM PLETE INITIALS